Abstract

The World Health Organization (WHO) has considerable evidence that several interrelated factors (e.g., smoking, hypertension, cholesterol, and obesity) contribute to total mortality. Data are presented documenting that glucose intolerance is also a risk factor for total mortality, as well as for cancer and cardiovascular mortality. The Kaunas-Rotterdam Intervention Study, which documented glucose tolerance and mortality in a cohort of men, shows a linear increase in total mortality with increasing blood glucose levels. By use of multiple logistic regressions, glucose was shown to be a significant risk factor (c = .2534, t = 4. 0) for total mortality. A paradigm is presented in which diabetes is placed as a disease and glucose intolerance as a risk factor within the total scheme for the development of noncommunicable diseases. The WHO action plan for integrated programs in noncommunicable diseases is discussed. The program expands on the experience gained by WHO investigators in community programs and proposes a cooperative effort globally in community-based programming.